More than five years after Canada legalized cannabis, the health-care system remains ill-equipped to guide patients in its use.
As pharmacists specializing in cannabis consultations, we encounter patients navigating a fragmented and inconsistent health landscape. The root cause? A critical lack of cannabis education – not just among the public but within the health-care system itself.
Despite growing interest in cannabis for medical conditions, most Canadians – and their health-care providers – lack the knowledge needed to make informed decisions. This is not surprising. The average Canadian medical or pharmacy school allocates little to no time to cannabis education, leaving future practitioners unprepared. A 2020 study revealed that Quebec’s medical students reported low exposure to cannabis-related topics, with many feeling unprepared to address these issues in clinical practice. The absence of formal education perpetuates a cycle in which health-care professionals are undertrained, and patients are underserved.
When patients cannot rely on their physicians or pharmacists for guidance, they often turn to budtenders – retail workers with anecdotal knowledge but no medical training. This reliance on non-expert advice leads to decisions that may not align with evidence-based care. For example, patients may be unaware of potential drug interactions or how cannabinoids like THC and CBD differ in their effects.
The data underscores this problem. A 2024 BMC Medicine study found that while chronic pain (67 per cent), anxiety (63.6 per cent) and sleep issues (61.8 per cent) were the most common conditions treated with cannabis, only 54.1 per cent of users had medical authorization. Similarly, the 2022 Canadian Cannabis Survey reported that 74 per cent of Canadians using cannabis for medical reasons did so without professional oversight. This disconnect between therapeutic use and medical guidance poses risks to patient safety.
What makes this lack of guidance even more concerning is that scientific evidence continues to build in support of cannabis as a legitimate therapeutic tool. While cannabis is not a cure-all, a growing body of research points to real, clinically relevant benefits that patients and health-care professionals alike need to understand.
Cannabis and cannabinoids have demonstrated potential health benefits in a range of therapeutic areas, supported by both pre-clinical and limited clinical research. According to Health Canada, there is evidence that oral cannabinoids such as nabiximols (a THC and CBD combination) may be effective in managing chronic pain, particularly neuropathic pain in conditions like multiple sclerosis and cancer. The Canadian Agency for Drugs and Technologies in Health (CADTH) also reviewed clinical studies and concluded that THC and CBD formulations provide pain relief in patients with treatment-resistant neuropathic pain. In terms of sleep, Health Canada notes that low doses of THC may reduce sleep onset latency and increase total sleep time; however, higher doses could disrupt sleep quality.
In the realm of mental health, cannabidiol (CBD) has shown promise as an anxiolytic. Health Canada references pre-clinical research where CBD reduced anxiety-like behaviours in animal models, and limited human trials suggest CBD may reduce symptoms of social anxiety disorder. Additionally, cannabinoids like nabilone, which is synthetic THC, have been investigated for their effects on post-traumatic stress disorder (PTSD). A small Canadian clinical trial published in Psychoneuroendocrinology found that nabilone significantly reduced the intensity and frequency of nightmares in PTSD patients. (It’s important to note that nabiximol and nabilone are regulated and can only be prescribed by physicians.
Fortunately, some progress is being made. Programs like the Medical Cannabis Core Education Program (MCCEP) offered by the B.C. Pharmacy Association and McMaster University’s The Science of Cannabis course are equipping health-care providers with essential knowledge. However, these initiatives remain limited in scope and accessibility. A national strategy is needed to integrate cannabis education into core medical and pharmacy curricula.
Additionally, continuing education opportunities must be expanded for practicing professionals. Many pharmacists and physicians express interest in learning about cannabis but face barriers such as stigma and limited access to credible training programs. Programs like Seneca Polytechnic’s Cannabis Industry Studies and the Integrative Medicine: Cannabis Certificate Program within The Michener Institute of Education offer promising models but need broader adoption.
Integrating cannabis education into mainstream medical training is not optional – it is essential. Avoiding this topic only ensures that misinformation will fill the gaps left by formal education. A national strategy should include:
- Core Curriculum Integration: All medical and pharmacy programs must include evidence-based cannabis education covering pharmacology, therapeutic applications and patient counselling.
- Continuing Education: Accredited programs should be made widely available to practicing professionals.
- Research Investments: Expanding the evidence base will empower health-care providers with robust clinical guidelines.
- Public Awareness Campaigns: Educating the public will complement professional training efforts.
A 2019 study found that three-quarters of Canadian medical trainees wanted more cannabis education to feel confident authorizing its use. Similarly, 91 per cent of nursing students identified significant gaps in their curriculum regarding both medical and recreational cannabis. These findings highlight an eagerness among future health-care providers to bridge this knowledge gap – but they need institutional support.
The legalization of cannabis was a watershed moment for Canada’s health-care system – but legalization without education has left patients vulnerable to misinformation. By prioritizing comprehensive cannabis education, we can empower health-care providers to deliver safe, effective care tailored to individual needs.
Knowledge should never be optional when it comes to health and wellness.
